Insurance Coverage
Model
Insurance Coverage
Model

Insurance Coverage

NEXPLANON is covered by most insurance plans.

The cost of NEXPLANON depends on your insurance plan. You may be able to get NEXPLANON for free, as a result of changes under the Affordable Care Act. However, for other insurance plans you may need to pay a co-pay, deductible, or other charges. You should check with your insurance provider or employer and ask if NEXPLANON is available to you at no cost.

Insurance coverage for NEXPLANON

NEXPLANON is covered by most health care plans. You will need to check with your insurance provider or employer to determine your specific coverage.

Find out if NEXPLANON is covered as a medical benefit:

STEP 1:

Call the customer service number listed on the back of your health insurance card. Be sure to write down the names of any people you speak with.

STEP 2:

Tell the representative that NEXPLANON is a physician-administered birth control drug (not a device) and that your physician will:

  •  Be prescribing NEXPLANON
  •  Order NEXPLANON for you
  •  Insert NEXPLANON during an office visit

STEP 3:

Ask the representative if NEXPLANON is covered.

If the answer is “no”, ask if NEXPLANON is covered as a pharmacy benefit.

To get information about your pharmacy benefit, you may have to call another number on the back (such as the pharmacy customer service number of your health insurance card) and speak to a different person.

To get information about your pharmacy benefit, you may have to call another number on the back (such as the pharmacy customer service number on the back of your health insurance card) and speak to a different person.

Repeat steps 1-3.

If NEXPLANON is covered:

STEP 1:

Ask the representative whether NEXPLANON and the insertion procedure are 100% covered. If it’s not, ask about other costs you may have.

STEP 2:

Ask the person to send verification of coverage to your health care provider, if possible.

STEP 3:

If written verification cannot be provided, write down the name of the person you spoke with and tell your health care provider that your health plan told you that NEXPLANON is covered.

STEP 4:

Make an appointment with your health care provider to have NEXPLANON inserted.

If NEXPLANON is not covered:

STEP 1:

Ask your health plan representative if there are circumstances under which a "medical exception" would be authorized.

STEP 2:

Tell your health care provider whether you would be willing to pay out-of-pocket. You can also ask your health care provider about payment plans that may be available.

Let your health care provider know what you’ve learned about your coverage.


 

NEXPLANON is a prescription medication for the prevention of pregnancy in women.

IMPORTANT SAFETY INFORMATION

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the accompanying Patient Information for NEXPLANON and discuss it with your health care provider. The physician Prescribing Information also is available.


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